Curb Ramps

Construction/Alteration Date (circle one):

Before 1/26/92

After 1/26/92

Facility Name/Address:

Date:

Location:

Surveyors:

Record your measurements in the blanks when they are provided. Do not circle a response for a question you are
directed to skip. If your answer to a question is no, but the choices are “Y” and “n/a,” circle “n/a” (not applicable).
(A circled “N” signifies a violation).

Describe each curb ramp’s location:

Curb Ramp D:

Curb Ramp A:

Curb Ramp E:

Curb Ramp B:

Curb Ramp F:

Curb Ramp C:

Curb Ramp G:

Refer
to #

Curb Ramp (CR) Questions

Curb
Ramp A

Curb
Ramp B

Curb
Ramp C

Curb
Ramp D

Curb
Ramp E

Curb
Ramp F

Curb
Ramp G

1

Is ramp of CR at least 36" wide
(not including flared sides)?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

"

"

"

"

"

"

"

2

Does CR have a
running slope of 8.33% or less?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

%

%

%

%

%

%

%

3

Does CR have a
cross slope of 2% or less?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

%

%

%

%

%

%

%

4

Does CR have a
gutter slope of 5% or less?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

%

%

%

%

%

%

%

5

Are transitions on and off CR flush and
free of abrupt level changes?Record the height of any level changes.

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

"

"

"

"

"

"

"

6

Does CR have detectable warnings?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

7

Can CR be blocked by legally parked cars?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

8

Is the sidewalk at the “top” of CR
at least 36" wide?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

"

"

"

"

"

"

"

9

Does CR have flared sides?If yes, answer one of the next two questions.
If not, skip to question 10.

Y

n/a

Y

n/a

Y

n/a

Y

n/a

Y

n/a

Y

n/a

Y

n/a

9.a

If the sidewalk at the “top” of CR is
48" wide or more, is the slope of the
flared sides 10% or less?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

%

%

%

%

%

%

%

9.b

If the sidewalk at the “top” of CR is
less than 48" wide, is the slope of the
flared sides 8.33% or less?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

%

%

%

%

%

%

%

10

If no flared sides, is there an obstruction or
grass on each side of CR that discourages
pedestrians from traveling across ramp?If the CR has flared sides, skip this question.

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

11

If CR is built-up to the curb, is it
outside the path of cars?If CR is not built-up to curb, skip this question.

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Answer the last two questions only if the CR is located at a marked crossing:

12

Is ramp of CR contained in markings?

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

13

If corner-type CR, is bottom landing at least
48" long and contained in crosswalk?If not corner-type CR, skip this question.

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

Y

N

"

"

"

"

"

"

"

Comments:

This survey form is designed to assist you in identifying common barriers to access – not all barriers. To identify all barriers, you must survey for compliance with §§ 4–10 of the ADA Standards